Services for Providers
Market trends toward greater provider risk sharing and value-based contracting offer providers many new opportunities at the cost of new financial risks. Managing that risk is essential for providers' success in the emerging payment landscape, so that you can focus on practicing medicine. AAS can provide assistance understanding, monitoring, and managing risk to currently or potentially risk-bearing providers, including hospitals and medical groups. A sampling of available service descriptions is provided below.

Experience Analysis & Reporting, IBNP Estimates, and Risk Adjustment Support

These traditional actuarial concerns of health plans are essential for risk-bearing providers to utilize in projecting and improving performance under risk sharing and value-based contracts. Detailed descriptions of potential services are included here.

Alternative Payment Model (APM) Analysis

AAS can support providers who are currently participating in or are considering participation in APM contracts with payers, such as Accountable Care Organizations (ACOs), the Medicare Shared Savings Program (MSSP), capitation arrangements, gain-sharing, and others. Possible services include:
  • Experience reporting, trend analysis, and forecasting;
  • Pro forma feasibility analysis of proposed payment models and contract terms;
  • Utilization and cost modeling to understand cost drivers;
  • Independent data analysis in support of contracting;
  • Capitation rate sufficiency analysis;
  • Population stratification for optimizing the impact of health management initiatives;
  • Settlement estimates for financial reporting.

Process Automation and Improvement

We love to design improvements and implement automated solutions to perform technical tasks so that you can focus on practicing medicine. Talk to us about your problems, and let's see if we can work together to reduce your repetitive technical task burden.

Ad Hoc Financial Analysis

AAS has extensive experience understanding problems facing health entities, analyzing healthcare data, and reporting findings to stakeholders in a manner that is clear, concise, understandable, and actionable. We are able to partner with you to discuss the challenges or opportunities you are facing, create clear strategies for using available data to understand the issue more deeply, and provide analytical and organizational support in implementing solutions.
Contact Us
info@apolloactuarial.com

+1 509 879 7572

25 W Main Ave, Suite 310
Spokane, WA 99201